Arrangement of Kent’s Repertory.
The same arrangement of each section is used throughout the book
so that the sequence once understood the
finding of any rubric is very simple.
First. - Time. Second. - Conditions {modalities}, in alphabetical
succession. Third. - Where there is condition of Pain it is
arranged as to:- (a) Locality, (b) Character. (c) Extension.
To illustrate, take a mental symptom Restlessness (page 72):
Restlessness in general, under which are found all those remedies
which have developed restlessness in the provers
or removed the symptom clinically.
Then as to time. - Day time; morning; forenoon; afternoon; evening;
night; midnight, and at some special hour.
Then conditions under which restlessness has been observed (given
in their alphabetical order).
Aggravation in open air; driving out of bed; during chill; after
dinner; during heat; before, during and after menses; mental labor;
during perspiration; on waking; while sitting, and many others.
All these “modalities,” when markedly present in a
case, have great selective value.
Let us now examine the section on Generalities. Here we find aggravations,
ameliorations, sensations and
reactions of the patient, as a whole, to some physical condition,
as to pain in general.
Under these rubrics where nothing is specified, aggravation is
understood. The arrangement of the
generalities is the same as throughout the other sections.
First, time - morning; noon; night; at particular portion of,
and at a particular hour.
After time follow general conditions of patient as a whole in
alphabetical order. (Aggravations and
ameliorations of various parts, head; eye; ear; nose; face; stomach;
chest; back; extremities; skin, etc., each is
found in the section referring to that part in particular.).
These general aggravations as found under this last section are
as follows: Better and worse from ascending;
bathing; from cold; from wet and dry; from position; form motion
and rest; from pressure; from rubbing, etc.
Under aggravation from cold we have the following particulars:
Cold in general; cold air; becoming cold; cold, dry
weather; entering a cold place; tendency to take cold; cold, wet
weather; cold feeling in blood vessels, bones and
inner parts. In looking for aggravations from wet and dry we find
under wet: Applications; getting wet; feet;
head; perspiration; weather.
Aggravations and ameliorations as to weather conditions and time
of year under: Weather and Autumn, warm, wet
weather (under Warm); Summer, Storms, as to approach of and during;
Spring, wet weather under Wet;
Wind as to cold, warm south, windy and stormy weather; cold, dry
and cold, wet weather is found under Cold.
Under this section we find the general character of Pain as to
its onset and its disappearance (gradual or sudden).
Its character, as burning; constricting; digging; drawing; jerking;
pinching; pressing; stitching; tearing, etc.
Its direction as to across; downward; inward; outward; upward.
We find inserted alphabetically throughout generalities nearly
all the pathological nomenclature that there is in the
book. Here are listed such rubrics as Anaemia; Arsenical poisoning;
Atrophy; Cancerous affection; Caries;
Chlorosis; Chorea; Convulsions (various forms);
Dropsy; Fai
Dtness (fainting); Glands; Measles; Mercury, abuse of;
Obesity; Quinine, abuse of; Scarlet fever; Syphillis, etc.
The character and frequency of the pulse are found in this section,
and it is grouped alphabetically as abnormal,
frequent; intermittent; small, slow; full; hard; soft; tense; weak,
etc.
Perspiration as to general effect is found here as giving no relief;
aggravation after, amelioration after, and
suppression of.
The characteristics and particulars of perspiration are found
under that Section, page 1257.
Aggravations from eating and drinking and from different foods
and drinks, as bacon; beer; bread; butter; fruit;
meat; milk; pastry; tea, etc., the kinds and condition of food;
dry food; frozen food; hot; rich; salt; sweet; sour and
warm drinks and foods. These are all found under foods, while the
desires, cravings and aversions to various foods
and drinks, hunger and thirst (these being expressed by sensations
from the stomach) are found under desires and
aversions in the stomach section, page 478.
The general aggravations and ameliorations before, during and after
menses are found in the generalities, while all important particulars
and common menstrual symptoms are found under Section Genitalia,
Female, page 712.
Many particulars having menstrual modalities will be found scattered
through all sections of the book, as,
for instance, Headaches with menstrual modifications, will be found
under Head section. Abdominal distress
modified by menses under pain in back section, and son through all
conditions.
Through everything throughout the book the same arrangement exists.
The aggravation or amelioration of
patient as a whole is found under generalities, but when referred
to a part or an organ its aggravation or
amelioration is always found in its place under the section dealing
with that particular part.
Pain, - One of the most frequent symptoms that the physician is
requested to remove is pain, and
where to find the particular pain symptom in the repertory is most
bewildering, unless we are familiar with
its arrangement. The plan here is the same as elsewhere, which always
carries one from what is more general
to what is most particular in its minutest detail. The first list
of remedies will be found to cover the time of
occurrence. Second, all conditions under which the pain is observed,
these are arranged in alphabetical
order so that any particular condition may be readily found. Third,
the locality of the pain. Fourth, the
character of the pain, and last, the part or direction to which
the pain extends. Keep this arrangement in mind
and you will have no trouble finding that for which you search.
To illustrate, let us examine pain in the extremities, which is
the longest and most complicated of all the pain
sections.
First (page 1022) we have a list of remedies which have been found
to have symptoms of pain in extremities.
Following this are two short rubrics, Right and then Left, and
Left then Right. Then follows condition as to
time, and then a long list of conditions arranged alphabetically,
under which pain in extremities is found, as,
before and during chill; after slight exertion; during menses; on
motion; rheumatic; syphilitic; wandering,
etc.
Then follows a list which localizes in general, as Pain in Bones,
in flexor Muscles; Joints, Nails; Upper limbs;
Shoulder; Upper arm; Elbow;
Forearm; Wrist; Hand; Fingers, and Thumb. These subdivisions of
upper arm are all worked out under
same general arrangement, as to time, condition and extension to
different parts. Cold; heat; damp; dry;
position and motion, as they aggravate and ameliorate in particular,
are all found in their alphabetical order.
Then follow the lower limbs, which are divided into their respective
parts and which are treated as to time,
condition, etc., exactly as the upper limbs. Thus having covered
localities in general we proceed to deal with
the character of the pain in its various divisions.
Here, again, the whole extremities are analyzed, as under Pain
Burning (page 1067); Burning generally, with
its time and other conditions.
Burning in the joints and nails.
Burning in upper limbs generally, with time, conditions and extremities.
Burning in all the localities of upper limbs, in each instance
with the time, modalities, conditions and
extension. Then follow the burnings in the localities of the lower
extremities arranged in the same way.
After one characteristic has been gone through exhaustively it
passes on to the next kind of pain each in
alphabetical order.
Pain whether in head, stomach, abdomen, chest or other part of
body in
gone through in this same general way into all its exhaustive
finalities. This arrangement is so important that it will bear
repetition.
First, Pain Generally: As regards time and conditions, Always
in alphabetical order.
Second, Pain localized with regard to time, condition and extension.
Third. Character of pain generally with regard to time, condition
and extension.
Fourth. Character of pain as related to each locality in its turn
(alphabetically) with continued reference to
time, conditions and extension.
It is well to remember one point in looking for symptoms in the
repertory, and that is, when you cannot find
the symptoms as given in the language of the patient, do not despair
and throw down the book in disgust, but look
for some synonym until you find what you are looking for, and when
you have found this, make a cross reference
in your repertory so it will be easier the next time.
Again, many fail to use the repertory because they think of symptoms
in pathological terms. Symptoms are recorded
in the materia medica in the language of the provers who were mostly
laymen, and as the repertory is simply and
index to the materia medica the rubrics must be in their simple
language.
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